Individual
DR. GEORGE AUGUSTUS NELSON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
4643 CAMP COLEMAN RD, SUITE 101, TRUSSVILLE, AL 35173-2821
(205) 655-0603
(205) 655-0693
Mailing address
4643 CAMP COLEMAN RD, SUITE 101, TRUSSVILLE, AL 35173-2821
(205) 655-0603
(205) 655-0693
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
3186
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
152289
UNITED CONCORDIA PROV #
AL
01
—
510-94984
BCBS OF AL PROV. NUMBER
AL
Enumeration date
11/18/2005
Last updated
02/09/2012
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